1979, 07-26 Permit: 79-1065 ACPLAN NUMBER
APPLICATION/PERMIT
SPOKANE COUNTY — BUILDING CODES DEPARTMENT
NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3675
APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 4 COPIES
JOB ADDRESS
3o
LEGAL DESCRIPTION — SEE ATTACHED
LOT
2.
BLOCK
SUBDIVISION
3
OWNER
ADDRESS
4.
S, 3 0
CONTRACTOR
Va-uv, c4 -
ADDRESS _ b
5.
PHONE
9 DS, -93i-1
ZIP
ONE
d$ -'25'a
• Ci3oG\ T7^ Q
DESIGNER
PHONE
ADDRESS
ZIP
PARCEL NUMBER/S
Required Set Backs in Feet
North 'SouthEast 'West
Size of Parcel Zone Classification
Type Const. Occupancy Sprinklered
❑Ves ❑No 0 Req'd.
Valuation Building Area In Sq. Ft.
DWL Area I Basement Area Garage Area Storage
CHANGE OF USE FROM
6.
TO
Split Entry
Split Level
Rancher
TYPE
7. OF
WORK
DESCRIBE5WORK
8.
Dr NEW
C BLD.
❑ ALT.
❑ PLMB.
AD N.
MECH:
❑ RPL.
❑ M.H.
❑ MVE.
0 POOL
0 OTHER
No. Baths
No. Floors
No. Rooms
Rec. Room
CERTIFICATE
of EXEMPTION
Req'd.
Recd.
Not Req'd.
VALUATION
9.
Source
of
Utilities
GAS
ELECTRIC
WATER
SEWER
I hereby certify that I have read and examined this application and have read the "NOTICE" provisions included
on reverse side, and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume
to give authority to violate or cancel the provisions of any other state or local law regulating construction or the
performance of construction.
DATE SIGNATURE
DEPT.
SPECIAL APPROVALS
REQ'D. REC'D.
Env. Hea Ith
Planning
Fire Marshall
Co. Engineer
()Unties
Zone Clearance
SEPA Checklist
SPECIAL CONDITIONS:
DATE
70g-77 OFFICIAL an tf/ N51
APPROVED FOR ISSUANCE
FEES COLLECTED
Single $
Building
Plumbing
Mech. 7 • U
Plan Check
SEPA
Mobile Home
Other (Specify)
TOTAL
$
1
PERMIT NUMBER
79—Ia
DATE 7-3J
04* *7.00
*7.00 {n
*7.006p 8
6 *000
10642
07-26-79
2 6479,
WHEN MACHINE VALIDATED IN THIS SPACE,
THIS BECOMES A PERMIT.
07-126-79 10655
*700WDe
0
v
W
0
Z